A Case of Gastric Cancer with Invasion to the Mucosal Layer and Paraaortic Lymph Node Metastasis

Kazuomi Iwasaki, Takuo Shinozaki, Satoshi Yamaguchi, Takafumi Urakawa, Kazuya Okada, Nobuo Tsuda*, Tomayoshi Hayashi*

Department of Surgery, Shimabara Onsen Hospital
*Pathology Division, Central Diagnostic Laboratoty, Nagasaki University Hospital

We report a case of gastric cancer limited to the mucosa that metastasized to the paraaortic lymph node. A 40-year-old man was admitted to our hospital complaining of epigastralgia and nausea. Radiologic and endoscopic examination of the upper gastrointestinal tract showed superficial spreading IIc type cancer in the antrum. Distal gastrectomy with R4 lymphadenectomy was performed. Pathological examination reveald poorly differentiated adenocarcinoma limited to the mucosa, 5.4×4.5 cm in size, and marked lymph vessel invasion in the submucosa, muscularis propria and subserosa. The tumor metastasized to the paraaortic lymph node. The patient is alive with no recurrence 1 year and 4 months after surgery.

Key words
gastric cancer limited to the mucosa, metastasis to paraaortic lymph node

Reprint requests
Kazuomi Iwasaki Department of Surgery, National Obama Hospital
93 Obama-cho, Minamitakagi-gun Nagasaki, 854-05 JAPAN

Accepted
September 8, 1993

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